Effect of posterior instrumented fusion on three-dimensional volumetric growth of cervical ossification of the posterior longitudinal ligament: a multiple regression analysis
Effect of posterior instrumented fusion on three-dimensional volumetric growth of cervical ossification of the posterior longitudinal ligament: a multiple regression analysis
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DOI：
10.1016/j.spinee.2018.03.002
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发表时间：
2018-10-01
期刊：
影响因子：
4.5
通讯作者：
Ha, Yoon
中科院分区：
文献类型：
--
作者：
Lee, Jong Joo;Shin, Dong Ah;Ha, Yoon
背景背景：尽管后纵韧带骨化（OPLL）是一种三维疾病，但传统的研究主要集中在二维测量上，难以准确确定后路减压（椎板成形术或椎板切除术融合）后OPLL生长的体积和分析影响OPLL生长的因素。目的：本研究旨在通过三维测量方法探讨影响上睑下垂体积增长的因素。研究设计/设置：这是一项回顾性病例研究。患者样本：自6月1日起，回顾性分析了83例经颈椎计算机断层扫描（CT）诊断为3节段以上的多节段颈椎OPLL患者。1998. 至2015年12月31日。结果测量：术前和最近的随访CT扫描测量了从C1椎到C7椎的OPLL体积。方法：回顾性分析83例患者的年龄、性别。体重指数、高血压、糖尿病、外翻类型、手术方法、术前颈椎曲度、术前和术后颈椎活动度。术前颈椎CT和最近随访的颈椎CT扫描被转换为数字成像和医学通信数据，并使用Mimics程序（Materialise, Leuven, Belgium）对OPLL体积进行三维测量。采用单因素和多因素分析分析OPLL体积增长情况。结果：平均随访时间为32.36（±23.39）个月。患者平均年龄54.92岁（±8.21岁）。在单变量分析。年龄较小（p= 0.037）和椎板成形术（p= 0.012）与较高的OPLL平均年增长率（%/y）显著相关。在多元分析中。只有椎板成形术（p= 0.027）与较高的OPLL平均年增长率（%/y）显著相关。椎板成形术组PIA度的平均年增长率（8.00 +/- 13.06%/y）比椎板切除融合组（1.16 +/- 9.23%/y）快约7倍。结论：与保留运动的椎板成形术相比，后路固定融合具有降低OPLL生长速率的作用。手术治疗多节段OPLL需要考虑患者的年龄和手术方式。(C) 2018爱思唯尔公司版权所有。
BACKGROUND CONTEXT: Despite the fact that ossification of posterior longitudinal ligament (OPLL) is a three-dimensional disease, conventional studies have focused mainly on a two-dimensional measurement, and it is difficult to accurately determine the volume of OPLL growth and analyze the factors affecting OPLL growth after posterior decompression (laminoplasty or laminectomy and fusion).PURPOSE: The present study aimed to investigate the factors affecting OPLL volume growth using a three-dimensional measurement.STUDY DESIGN/SETTING: This was a retrospective case study.PATIENT SAMPLE: Eighty-three patients with cervical OPLL who were diagnosed as having multilevel cervical OPLL of more than three levels on cervical computed tomography (CT) scans were retrospectively reviewed from June 1. 1998. to December 31, 2015.OUTCOME MEASURES: The OPLL volume from the C1 vertebrae to the C7 vertebrae was measured on preoperative and the most recent follow-up CT scans.METHODS: Eighty-three patients were retrospectively examined for age, gender. body mass index, hypertension, diabetes, type of OPLL, surgical method, preoperative cervical curvature, and preoperative and postoperative cervical range of motion. Preoperative cervical CT and the most recent follow-up cervical CT scans were converted to Digital Imaging and Communications in Medicine data, and the OPLL volume was three-dimensionally measured using the Mimics program (Materialise, Leuven, Belgium). The OPLL volume growth was analyzed using univariate and multivariate analyses.RESULTS: The average follow-up period was 32.36 (+/- 23.39) months. Patients' mean age was 54.92 (+/- 8.21) years. In univariate analysis. younger age (p=.037) and laminoplasty (p=.012) were significantly associated with a higher mean annual growth rate of OPLL (%/y). In multivariate analysis. only laminoplasty (p=.027) was significantly associated with a higher mean annual growth rate of OPLL (%/y). The mean annual growth rate of degrees PIA, was about seven times faster with laminoplasty (8.00 +/- 13.06%/y) than with laminectomy and fusion (1.16 +/- 9.23%/y).CONCLUSIONS: Posterior instrumented fusion has the effect of reducing OPLL growth rate compared with motion-preserving laminoplasty. Patients' age and the surgical method need to be considered in surgically managing the multilevel OPLL. (C) 2018 Elsevier Inc. All rights reserved.